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Contamination in Urine Samples Collected Using Bladder Stimulation and Clean Catch Versus Urinary Catheterization in
Arístides Rivas-García1, Jorge Lorente-Romero, María López-Blázquez
1From the Pediatric Emergency Unit, Hospital Universitario Gregorio Marañón, Madrid, Spain.
Insights
The clean catch (CC) method for collecting urine samples from infants under 90 days old is an independent risk factor for contamination compared to urinary catheterization (CATH). This finding is crucial for accurate pediatric diagnostics.
Area of Science:
- Pediatric Medicine
- Clinical Diagnostics
- Infectious Disease Research
Background:
- Accurate urine sample collection is critical for diagnosing infections in infants.
- Traditional methods like clean catch (CC) and urinary catheterization (CATH) have varying contamination risks.
Purpose of the Study:
- To compare the contamination risk between CC and CATH urine collection techniques in infants younger than 90 days.
- To identify the independent risk factors for urine sample contamination in this age group.
Main Methods:
- A case-control study was conducted in a pediatric emergency room.
- Urine samples from 473 infants (<90 days) collected via CC or CATH were analyzed.
- Univariate and multivariate analyses were used to estimate contamination risk.
Main Results:
- The overall contamination rate was 3.4% (16/473).
- Samples collected via CC had a higher contamination rate (6.8%) compared to CATH (1.6%).
- CC collection was identified as an independent risk factor for contamination (OR=5.61).
Conclusions:
- While overall contamination rates are low, the CC technique poses a significantly higher risk of sample contamination in infants under 90 days.
- Urinary catheterization may be a more reliable method for obtaining uncontaminated urine samples in this population.
Objectives:
The objective of this study was to compare the risk of contamination for urine samples collected from patients younger than 90 days using 2 different techniques: bladder stimulation and "clean catch" (CC) and urinary catheterization (CATH).
Methods:
A case-control study was carried out in the pediatric emergency room of a tertiary hospital between January 2016 and September 2017. All urine samples collected from patients younger than 90 days by CC or CATH were included. The incidence of contaminated urine samples was compared for both methods, and the risk of contamination was estimated using univariate and multivariate analyses.
Results:
A total of 473 urine samples were collected, 310 via CATH (65.5%) and 163 via CC (34.5%). The median age was 1.4 months (interquartile range, 0.8-2.1 months), and 54.1% were males. Seventeen patients had a history of urinary tract infection (3.6%), and 16 were diagnosed with a congenital urorenal anomaly (3.4%). Sixteen urine samples were found to be contaminated (3.4%): 5 collected via CATH (1.6%) and 11 via CC (6.8%). The univariate analysis revealed a greater risk of contamination in specimens obtained using CC versus CATH (odds ratio, 4.41; 95% confidence interval, 1.51-12.93), and the multivariate analysis confirmed CC collection as an independent risk factor for contamination (odds ratio, 5.61; 95% confidence interval, 1.83-17.19).
Conclusions:
The number of contaminated urine samples in infants younger than 90 days in our pediatric emergency department is low. However, using the CC urine collection technique seems to be an independent risk factor for sample contamination.
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